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Meeting the UK Government’s prevention agenda: primary care practitioners can be trained in skills to prevent disease and support self-management

Meeting the UK Government’s prevention agenda: primary care practitioners can be trained in skills to prevent disease and support self-management
Meeting the UK Government’s prevention agenda: primary care practitioners can be trained in skills to prevent disease and support self-management

Aims: the NHS Long Term Plan has a prevention focus and ambition to support patients to self-manage disease through improving health behaviours. An essential requirement of self-management is behaviour change, but many practitioners have not been trained in skills to support behaviour change. ‘Healthy Conversation Skills’ (HCS) training was developed at the University of Southampton for this purpose. This article reports on a pilot study that aimed to assess the feasibility of primary care practitioners adopting HCS in their routine practice. It describes their experiences and level of competence post-training.

 Methods: Health Education England (Wessex) commissioned HCS training for 18 primary care practitioners. Fifteen of these practitioners were subsequently observed in their consultations at one or two time points; face-to-face semi-structured, reflective feedback interviews were conducted immediately following the observations. Practitioners’ HCS competence was assessed from the observations and interviews using a previously developed and published coding rubric. The interview data were analysed thematically to understand practitioners’ experiences of using the new skills. 


Results: practitioners demonstrated competence in embedding the skills into their routine practice following HCS training. They reflected on how patients liked being asked questions, the usefulness of setting SMARTER (Specific, Measured, Action-oriented, Realistic, Timed, Evaluated and Reviewed) goals and the power of listening. They could also identify facilitators of skill use and ways to overcome challenges such as patients with competing priorities and organisational constraints. They found the skills valuable as a way of empowering patients to make changes to manage their own health. 

Conclusions: HCS are acceptable to primary care practitioners, can be readily adopted into their routine consultations and are a helpful strategy for supporting patients to make changes. HCS training has the potential to be a sustainable, scalable and effective way of contributing to the prevention agenda by supporting disease self-management, and hence of addressing today’s epidemic of lifestyle-related conditions.

1757-9147
Lawrence, Wendy
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Watson, Daniella
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Barker, Hannah
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Vogel, Christina
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Rahman, Em
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Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Watson, Daniella
26005c9f-779f-407b-b7e4-b7c9b812b6be
Barker, Hannah
94312934-2508-4d08-a5fe-6f54544f96cf
Vogel, Christina
768f1dcd-2697-4aae-95cc-ee2f6d63dff5
Rahman, Em
40dcaa0e-bf4a-4efa-928e-4c162b5030b7
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2

Lawrence, Wendy, Watson, Daniella, Barker, Hannah, Vogel, Christina, Rahman, Em and Barker, Mary (2021) Meeting the UK Government’s prevention agenda: primary care practitioners can be trained in skills to prevent disease and support self-management. Perspectives in Public Health. (doi:10.1177/1757913920977030).

Record type: Review

Abstract

Aims: the NHS Long Term Plan has a prevention focus and ambition to support patients to self-manage disease through improving health behaviours. An essential requirement of self-management is behaviour change, but many practitioners have not been trained in skills to support behaviour change. ‘Healthy Conversation Skills’ (HCS) training was developed at the University of Southampton for this purpose. This article reports on a pilot study that aimed to assess the feasibility of primary care practitioners adopting HCS in their routine practice. It describes their experiences and level of competence post-training.

 Methods: Health Education England (Wessex) commissioned HCS training for 18 primary care practitioners. Fifteen of these practitioners were subsequently observed in their consultations at one or two time points; face-to-face semi-structured, reflective feedback interviews were conducted immediately following the observations. Practitioners’ HCS competence was assessed from the observations and interviews using a previously developed and published coding rubric. The interview data were analysed thematically to understand practitioners’ experiences of using the new skills. 


Results: practitioners demonstrated competence in embedding the skills into their routine practice following HCS training. They reflected on how patients liked being asked questions, the usefulness of setting SMARTER (Specific, Measured, Action-oriented, Realistic, Timed, Evaluated and Reviewed) goals and the power of listening. They could also identify facilitators of skill use and ways to overcome challenges such as patients with competing priorities and organisational constraints. They found the skills valuable as a way of empowering patients to make changes to manage their own health. 

Conclusions: HCS are acceptable to primary care practitioners, can be readily adopted into their routine consultations and are a helpful strategy for supporting patients to make changes. HCS training has the potential to be a sustainable, scalable and effective way of contributing to the prevention agenda by supporting disease self-management, and hence of addressing today’s epidemic of lifestyle-related conditions.

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Accepted/In Press date: 4 November 2020
e-pub ahead of print date: 15 February 2021
Published date: 15 February 2021
Additional Information: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: Health Education England (Wessex) provided the funding to pilot Healthy Conversation Skills which informed the development of the Wessex Making Every Contact Count training and implementation tools and resources. Other funding sources comprise a block grant and other resources from the UK Medical Research Council and UK National Institute of Health Research Southampton Biomedical Research Centre. W.T.L. has received funds from Nutricia Ltd t/a Danone Specialised Nutrition for training and teaching, separate from this work. Publisher Copyright: © Royal Society for Public Health 2021.

Identifiers

Local EPrints ID: 444982
URI: http://eprints.soton.ac.uk/id/eprint/444982
ISSN: 1757-9147
PURE UUID: 206e903e-4c9b-4b25-bcdb-a587dbd926e7
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438
ORCID for Hannah Barker: ORCID iD orcid.org/0000-0003-2639-3503
ORCID for Christina Vogel: ORCID iD orcid.org/0000-0002-3897-3786
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217

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Date deposited: 16 Nov 2020 17:30
Last modified: 21 Nov 2024 02:46

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Contributors

Author: Wendy Lawrence ORCID iD
Author: Daniella Watson
Author: Hannah Barker ORCID iD
Author: Christina Vogel ORCID iD
Author: Em Rahman
Author: Mary Barker ORCID iD

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